Provider Demographics
NPI:1255766812
Name:REGENCY'S HOME & HEALTH CARE SERVICES INC
Entity type:Organization
Organization Name:REGENCY'S HOME & HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALPHONSE
Authorized Official - Middle Name:ORVELY
Authorized Official - Last Name:JOVIN
Authorized Official - Suffix:
Authorized Official - Credentials:CEHP, BS CHEMISTRY
Authorized Official - Phone:407-884-7668
Mailing Address - Street 1:267 MAUDEHELEN ST
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-1679
Mailing Address - Country:US
Mailing Address - Phone:407-884-7668
Mailing Address - Fax:407-884-7668
Practice Address - Street 1:267 MAUDEHELEN ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-1679
Practice Address - Country:US
Practice Address - Phone:407-884-7668
Practice Address - Fax:407-884-7668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9245089163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007747800Medicaid